Billy Creek Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

32794 Issued in AZ

Legal business name

BILLY CREEK CLINIC

Practice address

43 W White Mountain Blvd
Lakeside, AZ 85929-7002

Phone

(928) 367-4040

Fax

(928) 367-4042

NPI assigned

May 20, 2008

Last updated

May 27, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer L Larue

Title

Billing

Phone

(928) 333-5333

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard E Donnelly, P.A.-C.

  • Surgical Physician Assistant
  • Lakeside, AZ
  • NPI 1396729455
  NPD (past)
• Thomas Edward Hawkins, PA-C

  • Physician Assistant
  • Whiteriver, AZ
  • NPI 1033177688
  NPD (past)
• Sean Patrick Wilson, M.D.

  • Family Medicine Physician
  • Eagar, AZ
  • NPI 1184615650
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1679730493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 878",
            "city": "SPRINGERVILLE",
            "state": "AZ",
            "postal_code": "859380878",
            "telephone_number": "928-333-5333",
            "fax_number": "928-333-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 W WHITE MOUNTAIN BLVD",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859297002",
            "telephone_number": "928-367-4040",
            "fax_number": "928-367-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BILLY CREEK CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "LARUE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "928-333-5333"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": "32794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Banner Health (Banner Same-Day Care)
• Banner Urgent Care Arizona LLC
• Banner Urgent Care Arizona LLC
• Barnet Dulaney Perkins Eye Center II PLLC (American Vision Partners)
• Barnet Dulaney Perkins Eye Center, PC (American Vision Partners)
• Susan Bligh Robertson, CNM
• Blue Ridge School District No. 32
• Bornstein Medical PLLC
• Ian Kay Brimhall, DO
• Sarah Burnett

• Primary Care Clinic/Center in Lakeside, AZ
• Providers in Lakeside, AZ by specialty
• Primary Care Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.